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JazCardio > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Essential/primary hbp =

A

no underlying cause (90% of cases)

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2
Q

2ndry hbp =

A

has an underlying cause

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3
Q

In diabetes ___ complications of hyperglycaemia occur before ____

A

macrovascular before microvascular

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4
Q

Diagnosis of a metabolic disorder, more/=3 of the following:

A

abdominal obesity, high tris, low HDL-C, hbp and high fasting glucose

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5
Q

Complications of hypertension =

A

HF, cerebral haem, atheroma, renal failure, sudden cardiac death

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6
Q

NO and prostaglandins =

A

vasodilators

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7
Q

catecholamines and angiotensin 2 =

A

vasoconstrictors

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8
Q

increased protein intake causes renal blood flow to ___ > ___bp

A

increase renal flow

decreases bp

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9
Q

2ndry hypertension due to renal failure is almost always ___

A

salt sensitive

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10
Q

Causes of 2ndry hypertension

A

renal disease - glomerulo/pyelonephritis, cysts
endocrine - adrenal hyperplasia - Conn’s; Phaeochromocytoma
artery stenosis/coarctation of aorta
drugs eg. steroids

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11
Q

Phaeochromocytoma =

A

tumour of the adrenal medulla releases excess noradrenaline

increases TPR and CO

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12
Q

Conn’s syndrome =

A

excess aldosterone independent of RAAS

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13
Q

Cushing’s = excess ___

A

glucocorticoids

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14
Q

Benign hypertension definition =

A

asymptomatic and picked up incidentally

still life-threatening

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15
Q

Malignant hypertension definition =

A

accelerated hypertension - increase occurs over a short time - life threatening
Diastolic >130-140

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16
Q

Malignant hypertension can lead to -

A

cerebral oedema (seen as papilloedema), acute renal/HF
headache and cerebral haem
fibrinoid necrosis of vessels ie. blown apart

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17
Q

Benign hypertension can lead to -

A 
LV concentric hypertrophy => sudden death by low perfusion or arrhythmia
CCF
atheroma
stroke
renal disease
aneurysm rupture
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18
Q

CV mortality risk x2 with every __ increase in sbp and ___ increase in dbp

A

20 in sbp

10 in dbp

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19
Q

Offer ____ if clinic bp is >140/90

A

ABPM

20
Q

ABPM =

A

more/=2 bp measurements/hr during waking hrs - roughly 14/day
automatic

21
Q

HBPM =

A

2 seated bp measurements 1 min apart, record x2/day for 4-7 days
discard 1st days and average the rest
self measured

22
Q

Stage 1 hypertension =

A

clinically >=140/90 and A/HBPM >=135/85

23
Q

Stage 2 hypertension =

A

clinically >=160/100 and A/HBPM >=150/95

24
Q

Severe hypertension =

A

> =180 clinically or dbp clinically >=110

25
Q

Screening tests offered to anyone with hypertension

A

urine test - for protein
bloods - for glucose, electrolytes, creatinine, estimated glomerular filtration rate, chol.
Fundi - for hypertensive retinopathy
12-lead ECG

26
Q

Grade 1 hypertensive retinopathy

A

slight/mod narrowing of retinal arteries
AND
arterovenous ratio >=1:2

27
Q

Grade 2 hypertensive retinopathy

A

mod/severe retinal artery narrowing
AND
arterovenous ratio

28
Q

Grade 3 hypertensive retinopathy

A

bilateral soft exudates (cotton wool spots)/flame-shaped haems

29
Q

Grade 4 hypertensive retinopathy

A

bilateral optic nerve oedema = blurred disc - papilloedema
AND
hard (yellowish) exudates

30
Q

hbp in afro-caribbean/black don’t give __

A

ACEI/ARB first-line

31
Q

For those under 55 and Caucasian hbp stepwise treatment =

A

ACEI/ARB
>+CCB
>+thiazide
>+another diuretic/α/β-blocker + expert advice

32
Q

If >55yo or black with hbp stepwise treatment =

A

CCB
>+ACEI/ARB
>+thiazide
>+another diuretic/α/β-blocker+expert advice

33
Q

Fibromuscular dysplasia

A

Corkscrew in renal/cerebral artery

Commonest in young females, treatable cause of hypertension

34
Q

Causes widespread tumours and can cause phaeochromocytoma =

A

VHL - Von Hippel Lindau

defect in p53

35
Q

Truely resistant hypertension is only diagnosed if ___

A

don’t respond to spironolactone

36
Q

Spironolactone causes an increase in ___ must be monitored

Be cautious of use in patients with __/___

A

creatinine and K+

diabetes/slow GFR

37
Q

Podagra =

A

gout that involves joint at base of big toe

38
Q

Gout is a type of ____
Present with ____ joint
Due to ____

A

arthritis
red, hot, painful, tender, swollen joint
uric acid excess crystallises and coolness precipitaes it into the blood

39
Q

___—____—->uric acid

A

xanthine oxidase converts xanthine to uric acid

40
Q

_____ (drugs) can cause gout as cause ___ not to be excreted as well

A

thiazide diuretics

uric acid

41
Q

xanthine oxide inhibitors used to treat gout =

A

allopurinol, oxypurinol and phytic acid

42
Q

___ competes with uric acid at distal tubule and decreases its excretion

A

aspirin (worsens gout)

43
Q

____ can cause hbp by stopping production of prostaglandins and blocking NA+ excretion

A

Ibuprofen (NSAIDS)

44
Q

bp lowering drug used in pregnancy

A

methyldopa
labetalol
nifedipine
hydralazine (only if severe/ after 37wks as may cause neonatal thrombocytopaenia)

45
Q

If v high systolic bp but low/normal diastolic suspect

A

aortic regurgitation
OR
stiff arteries

JazCardio (15 decks)

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